ABSTRACT
The social isolation resulting from the COVID-19 pandemic has changed the population’s habits and raised health-related issues, such as low back pain. This study aimed to evaluate the prevalence and risk of chronic low back pain in university students during the social isolation of COVID-19. We used an online questionnaire, the STarT Back Screening Tool (SBST), to check for low back pain. The factors investigated: sociodemographic data, pain, sedentary behavior, and physical activity. For proportion heterogeneity, we used the chi-square test. The adjusted analysis used Poisson regression with robust variance. A total of 208 students participated in the sample. University students with a partner were twice as likely to have pain (PR=2.07; 95%CI). The prevalence of low back pain was 48.1%; 87% (PR=1.87; 95%CI: 1.09-3.21; p=0.027) higher in women. University students with obesity were 42% more likely to have low back pain (PR=1.42; 95%CI: 1.04-1.94; p=0.032); and with sedentary behavior were 35% more likely to have low back pain (PR=1.36; 95%CI: 1.02-1.81; p=0.038). In total, 82% of the sample presented low risk of chronicity. Many people presented low back pain during the social isolation imposed by COVID-19. This is a common, limiting problem that must be considered and treated as a health and research priority.
Keywords
Low Back Pain; COVID-19; Social Isolation; Students
RESUMO
O isolamento social decorrente da pandemia de COVID-19 alterou os hábitos da população e levantou questões relacionadas à saúde, por exemplo, a dor lombar. Este estudo teve por objetivo avaliar a prevalência e o risco de cronicidade de dor lombar em universitários durante o isolamento social. Para isso, foi utilizado um questionário on-line. O instrumento STarT Back Screening Tool (SBST) foi utilizado para verificar a dor lombar. Os fatores investigados foram: dados sociodemográficos, informações sobre dor e informações sobre comportamento sedentário e atividade física. Utilizou-se o teste de qui-quadrado para heterogeneidade de proporções. A análise ajustada foi realizada mediante regressão de Poisson com variância robusta. A amostra foi composta por 208 estudantes. Verificou-se que universitários com companheiro apresentaram duas vezes mais chance de dor (RP=2,07; IC95%) em comparação aos solteiros. A prevalência de dor lombar foi de 48,1%; sendo 87% maior nas mulheres (RP=1,87; IC95%: 1,09-3,21; p=0,027) quando comparadas aos homens. Universitários com comportamento sedentário apresentaram uma probabilidade 35% maior de ter dor lombar (RP=1,36; IC95%: 1,02-1,81; p=0,038); e obesos 42% (RP=1,42; IC95%: 1,04-1,94; p=0,032). O risco de cronicidade foi baixo em 82% da amostra. A dor lombar esteve presente na vida de muitas pessoas durante o isolamento social imposto pela COVID-19. Trata-se de um problema comum, limitante, e que deve ser considerado e tratado como prioridade em saúde e pesquisa.
Descritores
Dor Lombar; COVID-19; Isolamento Social; Estudantes
RESUMEN
El aislamiento social derivado de la pandemia del COVID-19 ha cambiado los hábitos de la población y planteado problemas relacionados con la salud, como el dolor lumbar. Este estudio tuvo como objetivo evaluar la prevalencia y el riesgo de dolor lumbar crónico en estudiantes universitarios durante el aislamiento social. Para ello, se utilizó un cuestionario en línea. Se utilizó la herramienta STarT Back Screening Tool (SBST) para detectar el dolor lumbar. Los factores investigados fueron: datos sociodemográficos, información sobre el dolor e información sobre sedentarismo y actividad física. Se utilizó la prueba de chi-cuadrado para la heterogeneidad de proporciones. El análisis ajustado se realizó mediante la regresión de Poisson con varianza robusta. La muestra estuvo conformada por 208 estudiantes. Se encontró que los estudiantes universitarios con pareja tenían el doble de probabilidades de tener dolor (RP=2,07; IC95%) en comparación con los estudiantes solteros. La prevalencia de dolor lumbar fue de 48,1%; siendo un 87% mayor en mujeres (RP=1,87; IC95%: 1,09-3,21; p=0,027) en comparación con los hombres. Los universitarios con comportamiento sedentario tenían un 35% más de probabilidad de tener dolor lumbar (RP=1,36; IC95%: 1,02-1,81; p=0,038); y obesos 42% (RP=1,42; IC95%: 1,04-1,94; p=0,032). El riesgo de cronicidad fue bajo en el 82% de la muestra. El dolor lumbar estuvo presente en la vida de muchas personas durante el aislamiento social provocado por el COVID-19. Es un problema común, limitante, que debe ser considerado y tratado como una prioridad en salud e investigación.
Palabras clave
Dolor Lumbar; COVID-19; Aislamiento Social; Estudiantes
INTRODUCTION
Musculoskeletal pain is frequent in the academic environment. Students spend many hours sitting, using notebooks and mobile phones, in sometimes inadequate postures. A recent study reported a high prevalence of musculoskeletal pain in the spine among university students, 54.5% of them with low back pain11. Morais BX, Dalmolin GL, Andolhe R, Dullius AIS, Rocha LP. Musculoskeletal pain in undergraduate health students: prevalence and associated factors. Rev Esc Enferm USP. 2019;53:e03444. doi: 10.1590/S1980-220X2018014403444.
https://doi.org/10.1590/S1980-220X201801...
. Low back pain is the leading cause of disability worldwide in recent years, higher in the age groups of the economically active population and in low and middle income countries22. Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67. doi: 10.1016/S0140-6736(18)30480-X.
https://doi.org/10.1016/S0140-6736(18)30...
.
Since most people experience low back pain at some point in their lives, it became one of the main reasons for seeking health care, in addition to the circumstances of the ongoing COVID-19 pandemic33. Prieto-González P, Šutvajová M, Lesňáková A, Bartík P, Bul’áková K, Friediger T. Back pain prevalence, intensity, and associated risk factors among female teachers in Slovakia during the COVID-19 pandemic: a cross-sectional study. Healthcare (Basel). 2021;9(7):860. doi: 10.3390/healthcare9070860.
https://doi.org/10.3390/healthcare907086...
. The World Health Organization (WHO) currently classified COVID-19, a disease caused by the SARS-CoV-2 virus, as a pandemic. To reduce the transmission of the virus and its complications, sanitary measures such as social distancing and isolation were adopted worldwide44. Falvey JR, Krafft C, Kornetti D. The essential role of home- and community-based physical therapists during the COVID-19 pandemic. Phys Ther. 2020;100(7):1058-61. doi: 10.1093/ptj/pzaa069.
https://doi.org/10.1093/ptj/pzaa069...
.
How individuals interconnect and incorporate themselves into communities deeply impacts on health and longevity55. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433.
https://doi.org/10.1016/j.jaut.2020.1024...
. Social isolation is an important concern in the well-being of the population, and relates with health problems55. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433.
https://doi.org/10.1016/j.jaut.2020.1024...
,66. Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: special focus in older people. Prog Cardiovasc Dis. 2020;63(3):386-8. doi: 10.1016/j.pcad.2020.03.009.
https://doi.org/10.1016/j.pcad.2020.03.0...
. Given the scenario caused by the pandemic, the population changed their habits and reduced practice of physical activities. These changes can lead to a large number of musculoskeletal dysfunctions44. Falvey JR, Krafft C, Kornetti D. The essential role of home- and community-based physical therapists during the COVID-19 pandemic. Phys Ther. 2020;100(7):1058-61. doi: 10.1093/ptj/pzaa069.
https://doi.org/10.1093/ptj/pzaa069...
.
Responsible for loss of productivity at work and high health costs, low back pain is a priority of health and research in Brazil77. Carregaro RL, Tottoli CR, Rodrigues DS, Bosmans JE, Silva EN, van Tulder M. Low back pain should be considered a health and research priority in Brazil: lost productivity and healthcare costs between 2012 to 2016. PLoS One. 2020;15(4):e0230902. doi: 10.1371/journal.pone.0230902.
https://doi.org/10.1371/journal.pone.023...
. The social distancing imposed by the COVID-19 pandemic raised health issues related to musculoskeletal pain, for example, low back pain. As a result, this study aims to evaluate the prevalence and risk of chronic back pain in university students during this period as a result of the pandemic.
METHODOLOGY
This is a prospective cross-sectional observational study. The convenience sample were university students of both sexes, with no age limit, regularly enrolled at the Universidade do Vale do Rios dos Sinos (Unisinos), in the municipality of São Leopoldo, state of Rio Grande do Sul. All participants signed the informed consent form.
Inclusion criterion was: to be regularly enrolled in the semesters 2020/1 and 2020/2 at Unisinos. Exclusion criteria were: any pain before the pandemic, any accident during the pandemic and, consequently, any musculoskeletal dysfunction.
Data collection were from December 16, 2020 to January 16, 2021, using an online questionnaire, published through social networks. The questionnaire was divided into blocks about sociodemographic data (age, gender, course, semester, marital status), pain (period, duration, region diagram, numeric rating scale, brief pain inventory), low back pain specifically (STarT Back Screening Tool - SBST), sedentary behavior and physical activity (International Physical Activity Questionnaire - IPAQ), as well as an open question for reports that have not been contemplated in the questionnaire.
The numeric rating scale (NRS) was used to quantify the level of pain intensity that the student felt during the pandemic until the time of data collection (March to May, June to August and September to December 2020). On a scale of whole numbers from 0 to 10, the patient selected the value that best represented the intensity of the pain: 0 means the absence of pain and 10 the maximum pain88. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404. doi: 10.1016/j.pain.2011.07.005.
https://doi.org/10.1016/j.pain.2011.07.0...
.
The brief pain inventory (BPI) - reduced version, which assess the intensity and interference of pain in the day-to-day, was also used. It offers a scale from 0 to 10, with 0 the absence of pain/no interference and 10 the maximum possible pain/total interference in the activities. The questionnaire has nine questions about pain in the last 24 hours and at the moment88. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404. doi: 10.1016/j.pain.2011.07.005.
https://doi.org/10.1016/j.pain.2011.07.0...
.
The SBST instrument was used to check for low back pain. Nine questions relate only to low back pain experienced in the last two weeks, and includes questions related to physical factors (pain) and psychosocial factors. Pain is classified as low, medium or high risk99. Pilz B, Vasconcelos RA, Marcondes FB, Lodovichi SS, Mello W, Grossi DB. The Brazilian version of STarT Back Screening Tool - translation, cross-cultural adaptation and reliability. Braz J Phys Ther. 2014;18(5):453-61. doi: 10.1590/bjpt-rbf.2014.0028.
https://doi.org/10.1590/bjpt-rbf.2014.00...
.
Sedentary behavior was defined by the time the individual spent, per day, performing activity without expending great energy, such as sitting at various times of the day1010. Healy GN, Clark BK, Winkler EAH, Gardiner PA, Brown WJ, Matthews CE. Measurement of adults' sedentary time in population-based studies. Am J Prev Med. 2011;41(2):216-27. doi: 10.1016/j.amepre.2011.05.005.
https://doi.org/10.1016/j.amepre.2011.05...
. Participants were physically active when they reached at least 150 minutes of physical activity per week, and insufficiently active as less than 150 minutes1111. Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. International physical activity questionnaire (IPAQ): study of validity and reliability in Brazil. Rev Bras Ativ Fis Saude. 2001;6(2):5-18. doi: 10.12820/rbafs.v.6n2p5-18.
https://doi.org/10.12820/rbafs.v.6n2p5-1...
, used data from IPAQ - short version.
Descriptive statistics were performed. Categorical variables were described by means of absolute (n) and relative (%), and numerical variables were estimated using measures of central tendency (mean) and variability (standard deviation). To evaluate the difference between proportions, the chi-square test was used for heterogeneity of proportions. The adjusted analysis was performed by Poisson regression with robust variance. The variables that obtained p<0.20 in the crude analysis were selected for the adjusted analysis. Adjusted prevalence ratios (PR) and their respective 95% confidence intervals (95% CI) were estimated for the associations. Statistical analysis used the software Stata version 12.0 (Stata Corporation, College Station, Texas, USA). The significance level considered was 0.05%.
RESULTS
From the 11,255 students enrolled at the university, 219 answered the questionnaire, but 11 were excluded due to pain caused by accident, totaling 208 university students. The mean age was 23.5±4.2 years. The sample size allowed to analyze the association between pain and the characteristics investigated, with a 95% confidence level, 80% power, and 1.35 prevalence ratio (PR).
Table 1 presents the general characteristics of the sample of university students investigated. After adjusted analysis, we noticed a statistically significant association between marital status and the occurrence of pain during the pandemic. University students in union or who lived with a partner were twice as likely to have pain throughout the pandemic compared to single university students or who did not live with a partner (PR=2.07; 95%CI: 1.,03-4.14; p=0.013).
The prevalence of low back pain in the last 15 days was 48.1% (95% CI: 41.2-54.9%) (Table 2). After adjusted analysis, we noticed a statistically significant association between marital status and the occurrence of pain during the pandemic. The prevalence of low back pain was 87% higher in women (PR=1.87; 95%CI: 1.09-3.21; p=0.027). University students with longer sedentary behavior (≥5hs/day) had a 35% higher probability of having low back pain (PR=1.36; 95%CI: 1.02-1.81; p=0.038) than university students with less time. University students with obesity had a 42% higher probability of having low back pain (PR=1.42; 95%CI: 1.04-1.94; p=0.032) (Table 2).
Applying the SBST, we found that 82% of the university students who reported low back pain in the last 15 days had low risk of chronicity, 14% medium risk and 4% high.
DISCUSSION
This study found a connection between marital status and the occurrence of pain during the pandemic period. We associated low back pain with women, sedentary behavior, obesity, and living with a partner.
Living with a partner has also been associated with pain. Despite corroborating other findings in the literature1212. Silva MC, Fassa AG, Valle NCJ. Chronic low back pain in a Southern Brazilian adult population: prevalence and associated factors. Cad Saude Publica. 2004;20(2):377-85. doi: 10.1590/s0102-311x2004000200005.
https://doi.org/10.1590/s0102-311x200400...
,1313. Meucci RD, Fassa AG, Paniz VMV, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskelet Disord. 2013;14:155. doi: 10.1186/1471-2474-14-155.
https://doi.org/10.1186/1471-2474-14-155...
, the reasons for this association are uncertain. Marital status is probably a risk marker, related to behavioral characteristics of ergonomic, occupational and household risk, which is not risk factor itself.
The relationship between women and low back pain is established in the literature. Several studies indicate that the prevalence of low back pain is higher in women than in men1414. Zavarize SF, Wechsler SM, Lima AB, Martelli A. Dor lombar crônica: implicações do perfil criativo como estratégia de enfrentamento. Journal of Management & Primary Health Care. 2014;5(2):188-94. doi: 10.14295/jmphc.v5i2.215.
https://doi.org/10.14295/jmphc.v5i2.215...
15. Jiménez-Trujillo I, López-de-Andrés A, Del Barrio JL, Hernández-Barrera V, Valero-de-Bernabé M, Jiménez-García R. Gender differences in the prevalence and characteristics of pain in Spain: report from a population-based study. Pain Med. 2019;20(12):2349-59. doi: 10.1093/pm/pnz004.
https://doi.org/10.1093/pm/pnz004...
-1616. Gouveia N, Rodrigues A, Eusébio M, Ramiro S, Machado P, Canhão H, et al. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey. Rheumatol Int. 2016;36(2):183-97. doi: 10.1007/s00296-015-3398-7.
https://doi.org/10.1007/s00296-015-3398-...
. Differences in the prevalence of low back pain between genders may be related to physiological characteristics, such as hormonal factors1515. Jiménez-Trujillo I, López-de-Andrés A, Del Barrio JL, Hernández-Barrera V, Valero-de-Bernabé M, Jiménez-García R. Gender differences in the prevalence and characteristics of pain in Spain: report from a population-based study. Pain Med. 2019;20(12):2349-59. doi: 10.1093/pm/pnz004.
https://doi.org/10.1093/pm/pnz004...
,1616. Gouveia N, Rodrigues A, Eusébio M, Ramiro S, Machado P, Canhão H, et al. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey. Rheumatol Int. 2016;36(2):183-97. doi: 10.1007/s00296-015-3398-7.
https://doi.org/10.1007/s00296-015-3398-...
. Many women also accumulate their professional work with household chores and childcare, generating an overload1414. Zavarize SF, Wechsler SM, Lima AB, Martelli A. Dor lombar crônica: implicações do perfil criativo como estratégia de enfrentamento. Journal of Management & Primary Health Care. 2014;5(2):188-94. doi: 10.14295/jmphc.v5i2.215.
https://doi.org/10.14295/jmphc.v5i2.215...
.
The prevalence of low back pain is associated with several causes and factors, such as sedentary lifestyle and obesity1717. Santos AC, Bredemeier M, Rosa KF, Amantéa VA, Xavier RM. Impact on the quality of life of an educational program for the prevention of work-related musculoskeletal disorders: a randomized controlled trial. BMC Public Health. 2011;11:60. doi: 10.1186/1471-2458-11-60.
https://doi.org/10.1186/1471-2458-11-60...
,1818. Nascimento PRC, Costa LOP. Low back pain prevalence in Brazil: a systematic review. Cad Saude Publica. 2015;31(6):1141-55. doi: 10.1590/0102-311X00046114.
https://doi.org/10.1590/0102-311X0004611...
. A study with women southern Brazil revealed that sedentary lifestyle was the greatest factor of association with chronic low back pain1919. Sant'Anna PCF, Watte G, Garcez A, Altmayer S, Olinto MTA, Costa JSD. Predictive factors of chronic lower back pain risk in women: population-based study. BrJP. 2020;3(3):228-33. doi: 10.5935/2595-0118.20200050.
https://doi.org/10.5935/2595-0118.202000...
. Another study, conducted in the state of São Paulo, showed that women who did some kind of physical activity had better quality of life and relief of low back pain2020. Mancin GB, Bonvicine C, Gonçalves C, Barboza MAI. Análise da influência do sedentarismo sobre a qualidade de vida de pacientes portadores de dor lombar crônica. ConScientiae Saude. 2008;7(4):441-7. doi: 10.5585/conssaude.v7i4.1376.
https://doi.org/10.5585/conssaude.v7i4.1...
. The social isolation imposed by the COVID-19 pandemic can contribute even more to the relationship between low back pain and sedentary lifestyle, since the prolonged period at home makes people more likely to become or remain inactive2121. He M, Xian Y, Lv X, He J, Ren Y. Changes in body weight, physical activity, and lifestyle during the semi-lockdown period after the outbreak of COVID-19 in China: an online survey. Disaster Med Public Health Prep. 2021;15(2):e23-8. doi: 10.1017/dmp.2020.237.
https://doi.org/10.1017/dmp.2020.237...
,2222. Lesser IA, Nienhuis CP. The impact of COVID-19 on physical activity behavior and well-being of Canadians. Int J Environ Res Public Health. 2020;17(11):3899. doi: 10.3390/ijerph17113899.
https://doi.org/10.3390/ijerph17113899...
.
Although necessary, social isolation measures had some negative effects on the health of the population. A recent study conducted in Asia, Africa and Europe showed that individuals who spent more time at home had more daily sitting time, in addition to negative results regarding physical activities and changes in eating behavior2323. Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 International Online Survey. Nutrients. 2020;12(6):1583. doi: 10.3390/nu12061583.
https://doi.org/10.3390/nu12061583...
. Obesity is a risk factor for low back pain, since the overload on joint structures, caused by excess body weight, increases the risk of spinal degeneration and musculoskeletal pain1313. Meucci RD, Fassa AG, Paniz VMV, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskelet Disord. 2013;14:155. doi: 10.1186/1471-2474-14-155.
https://doi.org/10.1186/1471-2474-14-155...
,2424. Meucci RD, Fassa AG, Faria NMX. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:73. doi: 10.1590/S0034-8910.2015049005874.
https://doi.org/10.1590/S0034-8910.20150...
.
According to the SBST scale, most students (82%) had low risk of chronicity, whereas 14% and 4% had medium and high risk, respectively. According the literature1919. Sant'Anna PCF, Watte G, Garcez A, Altmayer S, Olinto MTA, Costa JSD. Predictive factors of chronic lower back pain risk in women: population-based study. BrJP. 2020;3(3):228-33. doi: 10.5935/2595-0118.20200050.
https://doi.org/10.5935/2595-0118.202000...
, these findings confirm that physical factors interfere the most with low back pain. Individuals with a low risk of chronicity have good prognosis, even more when compared with medium and high risk chronicity levels, as probably psychosocial factors are involved in pain99. Pilz B, Vasconcelos RA, Marcondes FB, Lodovichi SS, Mello W, Grossi DB. The Brazilian version of STarT Back Screening Tool - translation, cross-cultural adaptation and reliability. Braz J Phys Ther. 2014;18(5):453-61. doi: 10.1590/bjpt-rbf.2014.0028.
https://doi.org/10.1590/bjpt-rbf.2014.00...
.
This study did not investigate psychosocial factors, such as anxiety, depression, mood changes, among others, because they could be related to both the pandemic and pain. This is a retrospective study, subject to limitations regarding memory bias. However, this effect is expected to be minimal, since low back pain is a remarkable event in people’s lives, especially in situations of social isolation, as during the COVID-19 pandemic.
CONCLUSION
Low back pain was present in the lives of many people during the social isolation imposed by COVID-19. Marital status, female gender, sedentary behavior and obesity were associated with a higher probability of low back pain in the university students evaluated in the study. It consists in a common, limiting problem that should be considered and treated as a priority of health and research.
REFERÊNCIAS
-
1Morais BX, Dalmolin GL, Andolhe R, Dullius AIS, Rocha LP. Musculoskeletal pain in undergraduate health students: prevalence and associated factors. Rev Esc Enferm USP. 2019;53:e03444. doi: 10.1590/S1980-220X2018014403444.
» https://doi.org/10.1590/S1980-220X2018014403444 -
2Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-67. doi: 10.1016/S0140-6736(18)30480-X.
» https://doi.org/10.1016/S0140-6736(18)30480-X -
3Prieto-González P, Šutvajová M, Lesňáková A, Bartík P, Bul’áková K, Friediger T. Back pain prevalence, intensity, and associated risk factors among female teachers in Slovakia during the COVID-19 pandemic: a cross-sectional study. Healthcare (Basel). 2021;9(7):860. doi: 10.3390/healthcare9070860.
» https://doi.org/10.3390/healthcare9070860 -
4Falvey JR, Krafft C, Kornetti D. The essential role of home- and community-based physical therapists during the COVID-19 pandemic. Phys Ther. 2020;100(7):1058-61. doi: 10.1093/ptj/pzaa069.
» https://doi.org/10.1093/ptj/pzaa069 -
5Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433.
» https://doi.org/10.1016/j.jaut.2020.102433 -
6Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Physical exercise as therapy to fight against the mental and physical consequences of COVID-19 quarantine: special focus in older people. Prog Cardiovasc Dis. 2020;63(3):386-8. doi: 10.1016/j.pcad.2020.03.009.
» https://doi.org/10.1016/j.pcad.2020.03.009 -
7Carregaro RL, Tottoli CR, Rodrigues DS, Bosmans JE, Silva EN, van Tulder M. Low back pain should be considered a health and research priority in Brazil: lost productivity and healthcare costs between 2012 to 2016. PLoS One. 2020;15(4):e0230902. doi: 10.1371/journal.pone.0230902.
» https://doi.org/10.1371/journal.pone.0230902 -
8Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404. doi: 10.1016/j.pain.2011.07.005.
» https://doi.org/10.1016/j.pain.2011.07.005 -
9Pilz B, Vasconcelos RA, Marcondes FB, Lodovichi SS, Mello W, Grossi DB. The Brazilian version of STarT Back Screening Tool - translation, cross-cultural adaptation and reliability. Braz J Phys Ther. 2014;18(5):453-61. doi: 10.1590/bjpt-rbf.2014.0028.
» https://doi.org/10.1590/bjpt-rbf.2014.0028 -
10Healy GN, Clark BK, Winkler EAH, Gardiner PA, Brown WJ, Matthews CE. Measurement of adults' sedentary time in population-based studies. Am J Prev Med. 2011;41(2):216-27. doi: 10.1016/j.amepre.2011.05.005.
» https://doi.org/10.1016/j.amepre.2011.05.005 -
11Matsudo S, Araújo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. International physical activity questionnaire (IPAQ): study of validity and reliability in Brazil. Rev Bras Ativ Fis Saude. 2001;6(2):5-18. doi: 10.12820/rbafs.v.6n2p5-18.
» https://doi.org/10.12820/rbafs.v.6n2p5-18 -
12Silva MC, Fassa AG, Valle NCJ. Chronic low back pain in a Southern Brazilian adult population: prevalence and associated factors. Cad Saude Publica. 2004;20(2):377-85. doi: 10.1590/s0102-311x2004000200005.
» https://doi.org/10.1590/s0102-311x2004000200005 -
13Meucci RD, Fassa AG, Paniz VMV, Silva MC, Wegman DH. Increase of chronic low back pain prevalence in a medium-sized city of southern Brazil. BMC Musculoskelet Disord. 2013;14:155. doi: 10.1186/1471-2474-14-155.
» https://doi.org/10.1186/1471-2474-14-155 -
14Zavarize SF, Wechsler SM, Lima AB, Martelli A. Dor lombar crônica: implicações do perfil criativo como estratégia de enfrentamento. Journal of Management & Primary Health Care. 2014;5(2):188-94. doi: 10.14295/jmphc.v5i2.215.
» https://doi.org/10.14295/jmphc.v5i2.215 -
15Jiménez-Trujillo I, López-de-Andrés A, Del Barrio JL, Hernández-Barrera V, Valero-de-Bernabé M, Jiménez-García R. Gender differences in the prevalence and characteristics of pain in Spain: report from a population-based study. Pain Med. 2019;20(12):2349-59. doi: 10.1093/pm/pnz004.
» https://doi.org/10.1093/pm/pnz004 -
16Gouveia N, Rodrigues A, Eusébio M, Ramiro S, Machado P, Canhão H, et al. Prevalence and social burden of active chronic low back pain in the adult Portuguese population: results from a national survey. Rheumatol Int. 2016;36(2):183-97. doi: 10.1007/s00296-015-3398-7.
» https://doi.org/10.1007/s00296-015-3398-7 -
17Santos AC, Bredemeier M, Rosa KF, Amantéa VA, Xavier RM. Impact on the quality of life of an educational program for the prevention of work-related musculoskeletal disorders: a randomized controlled trial. BMC Public Health. 2011;11:60. doi: 10.1186/1471-2458-11-60.
» https://doi.org/10.1186/1471-2458-11-60 -
18Nascimento PRC, Costa LOP. Low back pain prevalence in Brazil: a systematic review. Cad Saude Publica. 2015;31(6):1141-55. doi: 10.1590/0102-311X00046114.
» https://doi.org/10.1590/0102-311X00046114 -
19Sant'Anna PCF, Watte G, Garcez A, Altmayer S, Olinto MTA, Costa JSD. Predictive factors of chronic lower back pain risk in women: population-based study. BrJP. 2020;3(3):228-33. doi: 10.5935/2595-0118.20200050.
» https://doi.org/10.5935/2595-0118.20200050 -
20Mancin GB, Bonvicine C, Gonçalves C, Barboza MAI. Análise da influência do sedentarismo sobre a qualidade de vida de pacientes portadores de dor lombar crônica. ConScientiae Saude. 2008;7(4):441-7. doi: 10.5585/conssaude.v7i4.1376.
» https://doi.org/10.5585/conssaude.v7i4.1376 -
21He M, Xian Y, Lv X, He J, Ren Y. Changes in body weight, physical activity, and lifestyle during the semi-lockdown period after the outbreak of COVID-19 in China: an online survey. Disaster Med Public Health Prep. 2021;15(2):e23-8. doi: 10.1017/dmp.2020.237.
» https://doi.org/10.1017/dmp.2020.237 -
22Lesser IA, Nienhuis CP. The impact of COVID-19 on physical activity behavior and well-being of Canadians. Int J Environ Res Public Health. 2020;17(11):3899. doi: 10.3390/ijerph17113899.
» https://doi.org/10.3390/ijerph17113899 -
23Ammar A, Brach M, Trabelsi K, Chtourou H, Boukhris O, Masmoudi L, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 International Online Survey. Nutrients. 2020;12(6):1583. doi: 10.3390/nu12061583.
» https://doi.org/10.3390/nu12061583 -
24Meucci RD, Fassa AG, Faria NMX. Prevalence of chronic low back pain: systematic review. Rev Saude Publica. 2015;49:73. doi: 10.1590/S0034-8910.2015049005874.
» https://doi.org/10.1590/S0034-8910.2015049005874
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Financing source: nothing to declare
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Approved by the Research Ethics Committee: Opinion No. 4,464,4890.
Publication Dates
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Publication in this collection
05 Dec 2022 -
Date of issue
Jul-Sep 2022
History
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Received
01 Aug 2022 -
Accepted
10 Aug 2022